Cardiology Fellowship Education & Research

Longitudinal care in the outpatient setting provides for an appreciation of the natural history of an array of cardiovascular problems. It allows our fellows to become familiar with early manifestations and the evolution of chronic diseases, the psychosocial impact of disease, as well as effects and side effects of treatment. Fellows gain appreciation of time itself as a diagnostic and therapeutic tool. Longitudinal care also allows fellows to meaningfully participate in preventive aspects of cardiovascular diseases including behavior modification. Importantly, it also allows for the establishment of a sustained, trusting relationship between the patient and fellow.

Trainees are supervised directly by an individual faculty member on a one-on-one basis. On a given clinic day, the trainee reviews all of the new patients with a faculty member designated to the fellow’s clinic. Return visits are typically scheduled on a subsequent fellows clinic day. This way, the return visits are evaluated by the same fellow and supervised by the same staff cardiologist who originally saw the patient. This arrangement provides maximal continuity of care with regards to the patient, trainee and staff cardiologist.

As a fellow, you’ll attend a variety of educational conferences, including some outside of cardiology services. Key conferences include:

Cardiology Grand Rounds
The emphasis of this lecture series is on core curriculum, the current state of the art and controversies of a given topic. This conference spans a wide spectrum of topics, including basic science lectures on lipid metabolism, vascular endothelium biology, mechanics of left ventricular systolic and diastolic function, cardiac pathology and pharmacology as well as a variety of clinical topics. Presentations are given by Lahey faculty and expert guest lecturers from outside the institution. They are held each Thursday at noon. Lunch is provided.

Cardiac Catheterization Conference
While flexible in format, this is typically a case-oriented conference with an underlying theme. The fellow is responsible for gathering and presenting relevant clinical information, non-invasive data (including CXR, ETT, Nuclear and Echo). This is followed by presentations of hemodynamic then angiographic findings. The emphasis of discussion is on indication of procedure, integration of non-invasive and invasive data and impact on decision-making. The specific intervention is then discussed as well as the outcome with appropriate reference to the literature.

Echocardiography Conference
This conference features presentations on interesting echocardiographic studies. Emphasis is on recognition of pertinent findings, differentiation from artifact, differential diagnosis, derived hemodynamic data and the impact of findings on clinical decision-making.

EKG Conference
EKG conferences focus on interesting electrocardiograms. Tracings are typically shown as “unknown.” Findings are described and interpreted by a fellow, followed by additional analysis and commentary by faculty members.

Electrophysiology Conference
Presentation of interesting arrhythmias, mechanism, diagnosis and management. Presentation and discussion of intracardiac recordings, journal articles, cardiac rhythm management device related topics is given by the electrophysiology faculty and electrophysiology fellow. The conference is organized by Dr. Jonathan Silver and is held Wednesdays at 7:30 am in the Landsman Conference Room.

Fellows Presentation
This conference is dedicated to a formal in-depth, one-hour discussion of a selected cardiology topic. Topics for presentation may include a didactic topic, background and data of a fellow’s research project, or a state-of-the-art topic of controversy. Fellows are encouraged to discuss potential topics in advance with the program director and give the presentation in a formal manner with the use of slides. Fellows should submit the title of their presentation to the administrative assistant to the Program Director to be incorporated in the conference schedule. Each fellow is assigned one lecture per year.

Invasive Teaching Conference
This is an educational conference with emphasis on basic hemodynamic and angiographic principles.

Journal Club
Two fellows are responsible for conducting Journal Club each month. They identify and present peer-reviewed journal articles in conjunction with other fellows and faculty members.

Discussion focuses on a critical appraisal of:

• Article conclusions
• Clinical relevance
• Impact on medical decision-making
• Study design and strengths
• Use and limitations of biostatistics

Morbidity and Mortality Conference
Scheduled for the first Wednesday of each month. Through review of typically three morbidity and mortality cases selected by the Vice Chair of Quality and Safety. This conference emphasizes risk management and lessons learned from a given experience. Format includes a five-minute presentation of the clinical resume by the fellow involved in the case, followed by a discussion with the attending on record and a designated expert in the field among the faculty.

Research Conference
The conference may serve as a forum for various staff to list and discuss ongoing or potential research projects for consideration as well as research topics from physicians outside the institution. Original as well as multicenter trials may be discussed. Topics covered are broad and include project inception, patient recruitment efforts, data collection and analysis. Fellows may also use this conference to present data prior to an official presentation at a national meeting.

Vascular Conference
This is a multidisciplinary conference which highlights patients with complex peripheral vascular disease. Input is solicited from vascular medicine, radiology, vascular surgery and interventional cardiology. The conference takes place on Tuesday mornings and attendance is optional but strongly encouraged for cardiology fellows, particularly during Invasive rotation.

Medical Grand Rounds
We strongly encourage attendance at weekly Medical Grand Rounds to maintain your skills in internal medicine during your subspecialty training.

Research and scholarly activities, under the guidance of our faculty, are essential components of your training at Lahey. During your fellowship, you will: 

• Be encouraged to submit a research project to the Lahey Postgraduate Recognition Day Contest
• Complete at least one project for submission to a regional or national meeting and/or publication
• Develop competence in critical appraisal of new therapies in medical literature
• Gain firsthand experience with research project conception, literature review, IRB (Institutional Review Board) procedures and responsible use of informed consent and data collection and analysis
• Have an opportunity to engage in clinical trials taking part at Lahey, including multicenter trials for which we’re a participating site

Research Schedule

We allot the following time for research during your fellowship:

• First year—two weeks
• Second year—one month
• Third year—Typically two months (may be used exclusively for research or combined with an elective, depending on your interest and past academic productivity) 

If needed, you may arrange for up to four months of dedicated research time in your third year with the approval of your program director.